The family physicians raised their hands.
"I promise," they said, "to call my legislator next week. And the next week. And the week after that. And the following week."
FPs Press Congress on Liability, Education, Medicare and Medicaid Issues
By Leslie Champlin
• Washington
4/26/2005
AAFP Director John Sattenspiel, M.D., right, of Salem, Ore.; Jerome Connolly, senior government relations representative in the AAFP Government Relations Division, center; and FP James Lenhart, M.D., of Las Vegas on April 20 plan their strategy to hit Capitol Hill the following day.
With that, some 90 family physicians and AAFP chapter staff -- data, maps and personal stories in hand -- prepared their trek to the U.S. Capitol to pitch family medicine's legislative agenda.
The format: the Family Medicine Congressional Conference April 20 - 21. The task: Help lawmakers understand the need for medical liability reform and the implications of cutting federal Medicaid support, decreasing Medicare funds and slashing residency training support.
That's a tall order. This year promises to be grim, and family medicine advocates are in for a marathon that demands persistence, warned legislative aides to U.S. senators and representatives.
President Bush's 2006 budget would terminate funding for Section 747 of Title VII in the Public Health Service Act, which supports family medicine residency training programs. The budget also proposes a $60 billion cut in federal Medicaid spending.
"Whether Title VII will be fully funded is probably unlikely, because the budget is so tight," David McClendon, M.D., health policy fellow for Sen. Thad Cochran, R-Miss., told conference participants. "We'll do our best to make sure these programs are funded, but at what level is hard to say."
Susan Quantius, staff for the House Appropriations Subcommittee on Labor, HHS, Education and Related Agencies, agreed. "I hate to be the bad news bearer," she said. But with record deficits, tax cuts and military expenditures, lawmakers are "balancing the need for their district projects with national program interests, and they have more interest in their district projects," Quantius explained. "In this environment, the winners are being held level and the losers are terminated. It's hard to envision how we could completely restore Title VII."
Despite such forecasts, many legislative aides agreed during face-to-face meetings with Academy representatives that Title VII would survive. Their reassurances followed an April 8 letter signed by 51 Democratic and Republican representatives urging Reps. Ralph Regula, R-Ohio, chair, and David Obey, D-Wisc., ranking member of the House Appropriations Subcommittee on Labor, HHS, Education and Related Agencies, to restore Title VII funding to at least 2005 levels.
"The Title VII health professions programs … have been shown to increase minority representation in the health care workforce, which we believe is essential to our health system," the letter said. "At a time when the American people have come to rely on their health care providers more than ever, eliminating this resource would be devastating to the country's neediest communities."
That's a tall order. This year promises to be grim, and family medicine advocates are in for a marathon that demands persistence, warned legislative aides to U.S. senators and representatives.
President Bush's 2006 budget would terminate funding for Section 747 of Title VII in the Public Health Service Act, which supports family medicine residency training programs. The budget also proposes a $60 billion cut in federal Medicaid spending.
"Whether Title VII will be fully funded is probably unlikely, because the budget is so tight," David McClendon, M.D., health policy fellow for Sen. Thad Cochran, R-Miss., told conference participants. "We'll do our best to make sure these programs are funded, but at what level is hard to say."
Susan Quantius, staff for the House Appropriations Subcommittee on Labor, HHS, Education and Related Agencies, agreed. "I hate to be the bad news bearer," she said. But with record deficits, tax cuts and military expenditures, lawmakers are "balancing the need for their district projects with national program interests, and they have more interest in their district projects," Quantius explained. "In this environment, the winners are being held level and the losers are terminated. It's hard to envision how we could completely restore Title VII."
Despite such forecasts, many legislative aides agreed during face-to-face meetings with Academy representatives that Title VII would survive. Their reassurances followed an April 8 letter signed by 51 Democratic and Republican representatives urging Reps. Ralph Regula, R-Ohio, chair, and David Obey, D-Wisc., ranking member of the House Appropriations Subcommittee on Labor, HHS, Education and Related Agencies, to restore Title VII funding to at least 2005 levels.
"The Title VII health professions programs … have been shown to increase minority representation in the health care workforce, which we believe is essential to our health system," the letter said. "At a time when the American people have come to rely on their health care providers more than ever, eliminating this resource would be devastating to the country's neediest communities."
AAFP former Director Arlene Brown, M.D., of Ruidoso, N.M., discusses Medicaid funding with staff members from the office of Sen. Jeff Bingaman, D-N.M. Bingaman helped introduce a Senate amendment that, if accepted and adopted by the House, would replace the House's current proposal to cut $20 billion from Medicaid with a proposal to set aside $1.5 million to support a bipartisan Medicaid commission.
In addition, lawmakers offered a ray of hope on Medicaid: 44 Republican representatives signed an April 13 letter to Rep. Jim Nussle, R-Iowa, chair of the House Committee on the Budget, urging him to accept an amendment already attached to the Senate version of the federal budget. If accepted by the House, the Senate amendment would replace the House's current proposal to cut $20 billion from Medicaid with a proposal to set aside $1.5 million to support a bipartisan Medicaid commission.
Noting that "policy should drive the budget and not the budget drive policy," the 44 legislators said such a commission would "serve as a credible forum" to develop comprehensive Medicaid reform.
Sens. Gordon Smith, R-Ore., and Jeff Bingaman, D-N.M., introduced the amendment, which the Senate adopted 52-48 March 17.
A Medicaid rescue is possible for 2006. However, continued progress on Medicaid and other issues crucial to family medicine depends on persistent communication, said Bruce Lesley, health legislative aide to Bingaman. Grass-roots efforts created "a groundswell of support for the bipartisan Medicaid commission that was incredible," he told conference participants. "You are responsible for saving billions and billions of dollars for this program."
The trick for maintaining momentum: Persistently voice your opinions on issues important to family medicine and thereby create a critical mass of legislators and aides who are discussing those issues, Stephanie Vance, founder of AdVanced Consulting, a political consulting company in Washington, told conference participants. Family physicians should repeatedly voice their positions on Medicaid, Medicare physician payment, Title VII and medical liability reform, regardless of whether their representatives or senators serve on key committees, she said.
"You want to be specific and persistent," she said. "Tell a personal story about how these bills are going to affect you and your patients."
The Family Medicine Congressional Conference was co-sponsored by the Academy, the Society of Teachers of Family Medicine, and the Academic Family Medicine Advocacy Alliance, which includes the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors and the North American Primary Care Research Group.
